Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is potentially lethal, but it is also a treatable autoimmune disorder characterized by prominent psychiatric and neurologic symptoms. It is often accompanied with teratoma or other neoplasm, especially in female patients. Anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum are characteristic features of the disease, thereby suggesting a pathogenic role in the disease. Here, we summarize recent studies that have clearly documented that both clinical manifestations and the antibodies may contribute to early diagnosis and multidisciplinary care. The clinical course of the disorder is reversible and the relapse could occur in some patients. Anti-NMDAR encephalitis coexisting with demyelinating disorders makes the diagnosis more complex; thus, clinicians should be aware of the overlapping diseases.

Anti-N-methyl-D-aspartate receptor encephalitis associated with mediastinal teratoma: a rare case report and literature review

“…However, the non-specific and diverse symptoms often lead to misdiagnosis of the disease (11). Definitive diagnosis is established by detection of anti-NMDAR antibodies in CSF and/or serum (13,14). In our case, the patient exhibited prodromal flu-like symptoms, psychiatric and neurologic symptoms and no signs of meningitis; samples of CSF showed moderate increase of lymphocyte.…”

“…After a 2-month of hospital stay, our patient finally achieved complete recovery from anti-NMDAR encephalitis with no recurrence and sequelae. Prolonged hospital stays may be a problem due to significantly slower decrease of antibody titers within the CSF relative to the serum (14).…”

Encefalite autoimune anti recetor N-metil D-aspartato: relato de dois casos

“…Apesar de lenta e por vezes com recidivas (25%), a recuperação completa é a regra em 75-80% dos casos, sendo o diagnóstico e tratamento precoces fatores prognósticos fundamentais [5,11].…”

“…Os anticorpos são dirigidos contra os heterômeros NR1 e NR2 dos recetores NMDA em áreas do cérebro relacionadas à memória, personalidade, movimento e controlo autonômico [5].…”

“…O reconhecimento e tratamento céleres podem reverter a condição e limitar a morbidade neurológica [3,5].…”